Dhakwa Dominica, Mudzengerere Fungai H, Mpofu Mulamuli, Tachiwenyika Emmanuel, Mudokwani Florence, Ncube Blessing, Pfupajena Mutsa, Nyagura Tendai, Ncube Getrude, Tafuma Taurayi A
Family Health International 360, Harare, Zimbabwe.
Zimbabwe Health Interventions, Harare, Zimbabwe.
Front Reprod Health. 2021 Sep 28;3:656351. doi: 10.3389/frph.2021.656351. eCollection 2021.
Gaps still exist in reducing new HIV infections among adolescent girls and young women (AGYW) aged 10-24 years. High Internet coverage and mobile phone penetration rates present opportunities for the use of mobile health (mHealth) to support access to health services. We present results of an FHI 360 and Zimbabwe Health Interventions-implemented mHealth intervention for reproductive health (RH) and HIV testing service (HTS) referral among AGYW aged 10-19 years between October 2019 and September 2020. Adolescent girls and young women referred for RH and HTS under the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) program had automatic reminders sent to their phones to facilitate access to services through short message service (SMS) and also using a paper-based system. These data were captured in a web-based District Health Information System (DHIS) database, which captured the referral completion status of the AGYW. Data for AGYW referred for RH and HTS for the period October 2018 to September 2019 for the paper-based system and October 2018 to September 2020 for the mHealth were extracted from District Health Information System version 2 (DHIS2) database and analyzed using SPSS to generate descriptive statistics. The Chi-square test was used to assess differences in referral completion rates by age-group; marital status, district, and type of service, as well as differences between mHealth and paper-based referral completion rates within each of the groups for the variables above. A total of 8,800 AGYW referred for RH and HTS, where 4,355 and 4,445 were referred through the mHealth and paper-based systems, respectively. About 95.2% (4,148/4,355) and 87.8% (3,903/4,445) referred through mHealth and the paper-based system, respectively completed referrals. The median time for referral completion was 1 day (Range = 0-9 days) for mHealth and 11 days (Range = 0-28 days) for the paper-based system. AGYW referred through mHealth were 17.995 times more likely to complete the referral system than those referred through the paper-based system (OR =17.995; <0.001). Compared to the paper-based referral system the mHealth solution resulted in a higher, service referral completion rates and shorter turnaround time. We recommend expansion of the mHealth solution to all DREAMS supported districts to increase uptake of RH and HTS among AGYW aged 10-19 years.
在减少10至24岁少女和年轻女性（AGYW）中新发艾滋病毒感染方面，仍然存在差距。高互联网覆盖率和手机普及率为利用移动健康（mHealth）来支持获得卫生服务提供了机会。我们展示了FHI 360和津巴布韦卫生干预措施实施的一项移动健康干预措施的结果，该干预措施针对2019年10月至2020年9月期间10至19岁的AGYW提供生殖健康（RH）和艾滋病毒检测服务（HTS）转诊。在“坚定、坚韧、赋权、无艾滋病、有指导和安全”（DREAMS）项目下被转诊接受RH和HTS的少女和年轻女性会收到自动发送到其手机的提醒，以通过短信服务（SMS）并使用纸质系统来方便她们获得服务。这些数据被录入基于网络的地区卫生信息系统（DHIS）数据库，该数据库记录了AGYW的转诊完成状态。从地区卫生信息系统2（DHIS2）数据库中提取了2018年10月至2019年9月期间通过纸质系统以及2018年10月至2020年9月期间通过移动健康被转诊接受RH和HTS的AGYW的数据，并使用SPSS进行分析以生成描述性统计数据。卡方检验用于评估不同年龄组、婚姻状况、地区和服务类型的转诊完成率差异，以及上述各变量组内移动健康和纸质转诊完成率之间的差异。共有8800名AGYW被转诊接受RH和HTS，其中分别有4355名和4445名是通过移动健康和纸质系统转诊的。通过移动健康转诊的约95.2%（4148/4355）和通过纸质系统转诊的87.8%（3903/4445）分别完成了转诊。移动健康转诊完成的中位时间为1天（范围 = 0 - 9天），纸质系统为11天（范围 = 0 - 28天）。通过移动健康转诊的AGYW完成转诊系统的可能性是通过纸质系统转诊的AGYW的17.995倍（OR = 17.995；<0.001）。与纸质转诊系统相比，移动健康解决方案带来了更高的服务转诊完成率和更短的周转时间。我们建议将移动健康解决方案扩展到所有由DREAMS支持的地区，以提高10至19岁AGYW对RH和HTS的接受率。
